The Correlation Between Clinic And Home Pulse Rate Differences With The White Coat Effect In Treated Hypertensive Patients

Objective:This study aimed to evaluate the impact of the white coat effect(WCE)of BP on the difference between home and office RPR in treated hypertensive adults.Methods:This study included 277 adult patients with sinus rhythm attending the outpatient clinic of the Department of Cardiovascular Medicine,the Second Affiliation Hospital of Nanchang University.Patients have 7 days of home blood pressure and pulse rate recordings after the initial visit,and repeat visits one week later.At the follow-up visit patients have 3 blood pressure and pulse rate measurements after sitting and resting for 15 minutes in the clinical room.The WCE of BP was identified when the home Systolic/ Diastolic blood pressure(SBP/DBP)<135/85 mm Hg,but the office SBP/DBP was ≥ 140/90 mm Hg.The patients were divided into two groups,the WCE of BP(94 cases)and the no-WCE of BP(183 cases).The mean difference of BP and RPR between the office and home settings was recorded as ΔBP and ΔRPR.Results:1.The office RPR was 8.8 beats per minute(bpm)higher than the home value in the total group.The office RPR was similar between the two groups,but the home PRP level of the WCE group was lower,therefore the WCE group had a high level of ΔRPR(12.2±10.9bpm vs 7.1±9.2bpm,P <0.001).2.From this included population,there was found a positive correlation between ΔSBP and ΔRPR(β=0.32,P<0.001).3.Using RPR <80 bpm as a reference,the RPR control rate at home was 84%,but the office control rate was only 52%.Conclusion:Among the treated hypertensive patients in our study,the WCE of RPR was 8.8 bpm,and the WCE of RPR was positively associated with the WCE of SBP.